title: Gender differences in the predictors of depression among patients with heart failure.
abstract: BACKGROUND
  Depression is common in patients with heart failure. The prevalence of depression is known to differ in male and female patients with heart failure, but little is known about whether these patients differ in predictors of depression. The purposes of this study were to: (1) determine whether the prevalence of depression in patients with heart failure differed by gender: (2) examine if predictors of depression differed by patient gender.
  
  
  METHODS
  In this cross-sectional observational study, 147 patients with a primary diagnosis of heart failure completed five self-report questionnaires: demographic and clinical characteristic questionnaire, Mishel Uncertainty in Illness Scale, Beck Depression Inventory-II, Social Support Scale and Minnesota Living with Heart Failure Questionnaire. Data were analyzed with logistic regression.
  
  
  RESULTS
  The majority of subjects were male (54.4%), with a mean age of 71.04 ± 13.29 years and mean ejection fraction of 46.42 ± 17.02%. About two-thirds of male patients (65%) and of female patients (65.7%) had significant depressive symptoms (Beck Depression Inventory-II score ≥14). More female than male patients had moderate or severe depressive symptoms. Stratified analyses revealed that significant independent predictors of depressive symptoms among males were being unemployed (odds ratio=.09, 95% confidence intervals=.02- .54), lower ejection fraction (odds ratio=.96, 95% confidence intervals=.92-1.00), and worse quality of life (odds ratio=1.09, 95% confidence intervals=1.05-1.14); among females, predictors were uncertainty (odds ratio=1.09, 95% confidence intervals=1.04-1.32) and worse quality of life (odds ratio=1.17, 95% confidence intervals=1.08-1.48).
  
  
  CONCLUSIONS
  Different variables predicted the presence of significant depressive symptoms in male and female patients with heart failure, but quality of life was an important factor in predicting depression in both genders.
authors.affiliation: National Defense Medical Center, School of Nursing, Taiwan chiwenkao@ndmctsgh.edu.tw.
authors.forename: Chi-Wen
authors.initials: CW
authors.lastname: Kao
authors.affiliation: Chung-Jen College of Nursing, Health Sciences and Management, Taiwan.
authors.forename: Ting-Yu
authors.initials: TY
authors.lastname: Chen
authors.affiliation: National Defense Medical Center, School of Medicine and Department of Internal Medicine, Tri-Service General Hospital, Taiwan.
authors.forename: Shu-Meng
authors.initials: SM
authors.lastname: Cheng
authors.affiliation: National Defense Medical Center, School of Medicine and Department of Internal Medicine, Tri-Service General Hospital, Taiwan.
authors.forename: Wei-Shiang
authors.initials: WS
authors.lastname: Lin
authors.affiliation: University of Maryland, School of Nursing, USA.
authors.forename: Erika
authors.initials: E
authors.lastname: Friedmann
authors.affiliation: University of Maryland, School of Nursing, USA.
authors.forename: Sue Ann
authors.initials: SA
authors.lastname: Thomas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012737:Sex Factors; D012944:Social Support
keywords: Depression; gender difference; heart failure; quality of life; uncertainty